GP checks on patients with learning disabilities 'cut health inequalities'

An enhanced service that incentivises annual health checks for people with learning disabilities could reduce health inequalities and help pick up problems earlier, research suggests.

Blood test: health checks reduce health inequalities for patients with learning disabilities
Blood test: health checks reduce health inequalities for patients with learning disabilities

The study, published in Lancet Psychiatry, looked at data for over 8,600 patients from practices that opted in to the learning disabilities health check scheme enhanced service (LD-DES) to assess the impact of the scheme over its first three years.

It found that practices opted in to the scheme were twice as likely to diagnose co-morbidities such as thyroid disorders, gastrointestinal disorders and obesity in patients with learning disabilities.

Incentivised practices also carried out more blood tests and specific health assessments such as hearing and sight tests. They were more likely to refer patients to secondary care and devise health action plans.

People with intellectual disabilities (ID) tend to be at increased risk of comorbidities, including physical disabilities, sensory impairments, epilepsy and respiratory problems.

QOF-ID codes essential

But the researchers warned that many who would benefit from the tests were missing out. Data from the English Public Health Observatory indicate that nationally only 52% of patients eligible for the checks currently receive them.

They stressed that practices should ensure patients with disorders known to cause ID must have relevant ID Read codes added to their patient records to prevent them being excluded from the tests. Two in five patients with ID were excluded from tests due to this, they said.

The researchers said: ‘Our study indicates that primary care health checks for people with ID are associated with an increase in health-related activities as well as the identification of important comorbidities, which might lead to a reduction in avoidable deaths if effectively managed.

‘However we found that 40% of patients with specific ID syndromes (eg, Down's syndrome) did not have specific QOF ID codes recorded and were therefore not offered a health check.’

The LD-DES was implemented by NHS England in 2008/9, and rewards primary care teams for undergoing training and completing health checks on eligible patients.

Previous studies have shown that routine health check schemes in primary care may be beneficial to other high-risk groups, such as the frail elderly. But the benefits of a more general scheme launched in 2009 that indiscriminately targets all middle-aged patients have been widely debated.

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